Healthcare Provider Details

I. General information

NPI: 1619023918
Provider Name (Legal Business Name): VISHAL SAGAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PHALEN BLVD - MS 41103C HEALTHPARTNERS SPECIALTY CENTER 401
SAINT PAUL MN
55130-5302
US

IV. Provider business mailing address

8170 33RD AVE S MS21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-7850
  • Fax: 651-254-7857
Mailing address:
  • Phone: 952-883-5375
  • Fax: 651-254-7857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number49361
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: